When it comes to treating RLS, my go-to medication is gabapentin. I rarely (and possibly could say never) prescribe dopamine agonists. Once you've treated one patient with augmentation and have seen the overwhelming discomfort it can cause a patient, you would likely feel how I feel about the dopami...

I rarely use pregabalin for RLS. Some patients with RLS have coexisting neuropathic pain, and pregabalin can be helpful in some of these patients. Even in these cases, it is still useful to evaluate for iron deficiency, as underlying sources of blood loss can precipitate or worsen RLS.

I also use the regular formulation of gabapentin. Keep in mind that because of nonlinear kinetics and substantial interindividual variability, the gabapentin dose often does not always reflect serum level, especially at single doses above 600 mg. So I'll space the doses at least 2 hours apart. If yo...

I very rarely use Lyrica for RLS, unless there are comorbidities that would support its use, e.g., in the setting of fibromyalgia where drugs such as duloxetine would worsen RLS symptoms. More frequently, I use gabapentin. I prefer the long-acting formulations, but patients also do well with multipl...

I usually try DA agonists first (ropinirole or pramipexole). If they fail (or the pill burden is too much), then I will try gabapentin.I use Lyrica more as a 2nd or 3rd line agent. It's also important to make sure hypoferretinemia has been ruled out. Some studies suggest that central iron deficiency...

I certainly continue to use dopamine agonists, especially the fact that at the current time, a lot of the third-party payers seem to finally start paying for the generic extended-release options. This was not the case up to recently and some of the dreaded Medicare Advantage groups still don't. I am...

The management of Restless Legs Syndrome (RLS) is multifaceted and requires a personalized approach, taking into account the underlying etiologies, patient comorbidities, and individual response to treatment.  If RLS coexists with neuropathic pain, I typically utilize medications such as Pre...